How did you hear of this opening? *
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Newspaper Ad
Billboard Ad
On-Line Ad
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Other
PERSONAL INFORMATION
Last Name *
First Name *
Middle Name *
Street *
Country/Region *
- Select - Canada
United States
State/Province *
City *
Zip *
Phone No. *
Cell Phone No. *
Email *
Driver’s License No *
State *
Expiration Date *
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(MM-DD-YYYY)
Class/Endorsements
Position Applied For: *
Date Available: *
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2010
2011
2012
(MM-DD-YYYY)
Pay Requirement: *
Have you ever been employed by Shaffer Sports Events or a subsidiary of Shaffer Sports Events?
If so, What company and Dates?
Do you have a relative employed by this company?
If Yes, Name/Relationship:
In case of emergency, notify:
EDUCATION
HIGH SCHOOL
DID YOU GRADUATE?
If no, did you obtain a GED?
COLLEGE
DID YOU GRADUATE?
MAJOR COURSES
DID YOU GRADUATE?
MAJOR COURSES
PERSONAL REFERENCES
ADD 3 PERSONAL REFERENCES (NOT RELATED TO YOU)
(Name, Relationship, Occupation, Years Known, Phone)
SPECIFIC TRAINING
JOB SPECIFIC TRAINING
Do you have a legal right to work in the United States?
Did you serve in the U.S. Armed Forces?
If yes, what branch?
Rate or Rank at Discharge:
Type of Discharge:
PLEASE PROVIDE A COPY OF YOUR DD214
• Have you ever been arrested, convicted or adjudicated of a crime?
• Have you ever been convicted in a military court martial?
• Have you ever been sanctioned or had your licenses suspended or revoked?
• Are you currently under any investigation or pending charge?
*Answering Yes to any of the above questions DOES NOT automatically bar employment.
EMPLOYMENT HISTORY
Give a complete record of all employment, including military, and reasons for periods unemployed during the past 10-years. Start with the most recent. If you have served in the armed forces, attached a copy of your DD214. If you have been self-employed, list up to 5 of your major clients. (Note: List employers in reverse order starting with the most recent. Add another sheet if necessary. No “see resume” responses will be accepted.
Regulated/CDL - Applicants who will drive a regulated vehicle¹ shall provide (10) ten years’ information on those employers for whom the applicant operated such vehicle.
Are you employed now?
May we contact your current employer?
ACTUAL OR MUST RECENT EMPLOYMENT INFORMATION 1
COMPANY NAME
FULL ADDRESS
(Street, City, State, Zip)
PHONE NUMBER
CONTACT PERSON
POSITION HELD
DATE
SALARY - Starting / Ending
CHECK BOX AND STATE REASON FOR LEAVING
COMMENT
Was position subject to FMCSA, FAA, USCG and/or PHMSA regulation?
Was position regulated by Federal or State drug and alcohol testing requirements?
PREVIOUS EMPLOYMENT INFORMATION 2
COMPANY NAME
FULL ADDRESS
PHONE NUMBER
CONTACT PERSON
POSITION HELD
DATE
SALARY - Starting / Ending
CHECK BOX AND STATE REASON FOR LEAVING
COMMENT
Was position subject to FMCSA, FAA, USCG and/or PHMSA regulation?
Was position regulated by Federal or State drug and alcohol testing requirements?
PREVIOUS EMPLOYMENT INFORMATION 3
COMPANY NAME
FULL ADDRESS
FULL ADDRESS
PHONE NUMBER
CONTACT PERSON
POSITION HELD
DATE
SALARY - Starting / Ending
CHECK BOX AND STATE REASON FOR LEAVING
COMMENT
Was position subject to FMCSA, FAA, USCG and/or PHMSA regulation?
Was position regulated by Federal or State drug and alcohol testing requirements?
Security Code: *
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